Moving picturesof health

The 2020s are already like a sci-fi movie. Weaponized drones are out there inciting international conflicts, and I’m here politely asking the Google robot to turn down the Spotify so I can Facetime my sister while cooking a whole chicken in 30 minutes in the instant pot. The breadth of technology ought not to surprise anyone at this point.

So get this: the '20s is the decade when, if you end up in the hospital for whatever reason, it's possible a nurse will offer you a virtual reality (VR) headset as part of your patient care services. You pull some lightweight goggles over your face, shutting out the world of fluorescent lights and incessant beeping, and suddenly you're lounging in the serenity of a sunny beach—the gentle din of ocean waves in your ears. I'll leave it up to you to dream of whatever other fanciful virtual escape you'd prefer to take; I'm sure it has already been developed.

It might sound like the beginning of an episode of Black Mirror, but the intersection of health care and virtual reality is happening right now in Reno.

From TV to 3-D

Down in an office complex on Lakeside Drive is the headquarters of Healing HealthCare Systems. They make videos combining ambient music with tranquil, beautiful landscapes. It's called the Continuous Ambient Relaxation Environment (C.A.R.E) Channel, and it plays 24 hours a day on the televisions at hospitals, urgent cares, specialty units, waiting rooms—pretty much any place a patient might be. The company says they're available in more than 1,000 health care facilities around the world.

If you've ever been to the Peppermill, it's kind of like the nature videos playing on those massive screens everywhere.

“It's therapeutic content meant to calm people down, reduce anxiety and offset the amount of pain medication people use,” said Ford Corl, creative director of the C.A.R.E. Channel. “It's a good way to fill the room with positive vibes when hospital rooms can be negative, sterile places.”

Corl and his team travel to remote places to capture the videos on ultra high-definition cameras. They film everything from mountains and oceans to waterfalls and wildlife, each environment edited together to mesmerize patients into peaceful bliss.

It occurred to Corl that the future of this type of content might be in VR. He said a few years ago he started noticing companies like Samsung and Nokia developing virtual reality platforms, and he realized it was time to begin experimenting in that medium.

Fast forward to today, Healing HealthCare Systems now offers a product called C.A.R.E. VRx, their virtual reality headset and application that immerses patients inside of those signature C.A.R.E. Channel environments as if they were really there, and not stuck in their hospital bed.

Virtual Reality comes in different forms. One form is graphically developed 3-D worlds—something like a video game. These experiences are even designed using the same software as video games. I don't know if you've played video games lately, but they're incredibly lifelike. When you see this stuff in a headset, it can seem as good as real. You can squat down and look under things. You can pick things up. In some applications, you can even hang out with other people in their own VR headsets from all over the world. You're interacting with the avatar forms of these people, of course, and those avatars can range from anime cartoons to realistic humanoids. Have you read Ready Player One (or seen the movie)? A lot of the technology in that story has arrived already.

With all of that said, none of that is what C.A.R.E Channel VR is like. They're creating a type of VR immersive experience called 360 video. It's exactly what it sounds like, a video that spans 360 degrees around you. It captures environments as they are, which is a big deal when the environments are beautiful locations one might never see in a lifetime.

Their VR content is categorized—mountains or waterfalls, for example. In the course of the experience, the video passes through a number of different locations. The fidelity of these videos is extremely high—the details extremely clear. The world appears as if you were right in that spot.

However, unlike 3-D video games, you can't go exploring the environment around you. You can't pick things up. There are no levels to win or achievements to unlock. Arguably, that's the point. Patients are in these experiences to escape distracting stimuli.

The entire brand of the C.A.R.E Channel is based around serene healing environments. They believe in their philosophies enough to qualify them on their website with a selection of self-published blogs, white papers and articles written by Healing HealthCare Systems President and CEO Susan E. Mazer, Ph.D. Her March 22, 2019 blog is titled “Virtual Reality for Non-Pharmaceutical Pain Management.”

Getting into Hospitals

Virtual reality being the C.A.R.E. Channel's newest product, now it's their job to sell it to their portfolio of existing and future health care facilities. But getting hospitals to buy into VR isn't easy.

“I think hospitals are slow to adapt to new technology and rightfully so,” said James Vinall, Director of Sales at the C.A.R.E. Channel. “They want to make sure [VR is] evidence-based.” There's peer-reviewed research on the topic, but the jury is still out on embracing widespread VR.

Once a hospital buys the C.A.R.E. Channel VRx subscription, then they have to decide how they want to roll out their offering for VR. For example, would it be available to all patients, or only available in the oncology unit? There are other concerns about managing infection control if multiple patients use the same VR headset. Best practices for VR in health care are new and are being developed on an ongoing basis. The C.A.R.E. Channel staff say they consult on these best practices.

Vinall said that the technology is still in a trial phase. They're betting on a shift to an industry-wide adoption of virtual reality. It may require looking at how VR may help more people than just hospital patients.

“We've been getting a lot of interest from nurses and from hospital staff using a product like this,” said Corl. “A lot of hospitals are trying to mitigate nurse burn-out because of the long hours and weird schedules.” Corl shared anecdotes of hospital staff using VR as a way to chill out and escape during their breaktimes.

According to Renown Health's Director of Service Excellence Amber Maraccini, Ph.D, Renown has been a client of the C.A.R.E. Channel for roughly three years. The video service is available in all patient rooms, outpatient offices and elsewhere. However, Renown isn't using their Virtual Reality service.

“I think we're lightyears from [VR being offered to] every patient in every bed in the hospitals,” said Maraccini. She said that they're not opposed to it, however. “We're always looking to explore new opportunities and best practices. Knowing the research to support VR, I think there's a lot of applications for health care we haven't yet tapped into.”

She said implementation might look like slowly introducing VR for dedicated programs and dedicated spaces in the hospitals.

Meanwhile at Reno's VA Sierra Nevada Health Care System on Kirman Avenue, virtual reality is already being incorporated into a few different programs, some that are being recognized by the National Veterans Affairs department.

According to Colin McNerney, health systems specialist with the Reno VA, they initially made VR available in their recreation therapy department. Patients could explore different experiences as a way of recreation and disctraction. McNerney said he's never heard of the C.A.R.E. Channel. Instead, the VA offers consumer platforms for their Veterans to experience.

McNerney also explained that the VA uses VR for pain management for their chronic pain and hospice patients.

“We're using VR as a therapy model with vital sign capture and data capture to take the place of regularly schedule opioid prescription,” he said. “The goal is to implement VR instead of the patient popping a pill.”